Experts call for more collaborative approach to cancer care in Hong Kong

Expert panel members of the Oncology Innovation Study Group (from left) Dr. Raymond Lo, Dr. Polly Cheung, Dr. Alexander Chiu, Sabrina Chan, Dr. Stephen Chun Key Law and Chow Sau Fong call for collaboration in the development of a cancer strategy.

Healthcare professionals, NGOs, the pharmaceutical industry, insurance companies, cancer patient groups and community leaders must join hands in the fight against the high burden of cancer in Hong Kong, according to the Oncology Innovation Study Group (OISG).

"A people-centred cancer strategy based on a more integrated, and multi-disciplined model needs to be urgently introduced for better patient outcomes," OISG experts said. The Cancer Burden

According to studies, cancer ranks as the number one leading cause of death in Hong Kong, accounting for 30 percent or 13,803 of all registered deaths in 2014, a significant increment of 17 percent compared to a decade ago. New cancer cases have also been rising at 3.1 percent per year over the past decade, reaching 29,618 in 2014.

OISG commissioned KPMG to conduct a study, “Improving Patient Outcomes -- A Cancer Strategy for Hong Kong,” to identify gaps in the WHO's framework of patient's pathway in five key areas from prevention, screening, diagnosis, treatment to palliative care.  

Hong Kong was benchmarked with six other countries/regions including the UK, Australia, Singapore, Taiwan, Sweden, and France in this study.

According to OISG, cancer patients face a complex journey once diagnosed. They visit multiple healthcare providers, specialty fields of testing, hospital units and organizations.  They also see a multitude of physicians, radiologists, chemotherapy, nurses etc.  

An integrated approach to coordinate care and optimize resources is therefore urgently needed. One of the inevitable circumstances that cancer patients face today is the long waiting time from diagnosis to their first treatment. 

"Research evidence has shown that with palliative care incorporated early, advanced cancer patients' pain and depression can be improved with better quality of life, and their quantity of life can be further extended, too," said Dr. Raymond Lo, an OISG Expert Panel Member.

Cancer patients also need affordable access to cancer medicines in a timely manner.  Yet, out of the 26 cancer medicine approved by the European Medicine Agency in 2003-14 and indicated for major cancers, patients in Hong Kong can only receive subsidies to one-third of them through public funding. 

These facts and figures present a critical call for urgent attention to all stakeholders to jointly deliver more integrated cancer care in Hong Kong.  

"The public healthcare system in Hong Kong has been doing a great job in cancer care given the number of resources allocated. Within the community, there are actually many other stakeholders that can contribute to speed things up and make cancer control a much more integrated public health strategy. Shorter waiting times, early integration of palliative care, timely and affordable access to cancer medicines are key issues to deliver better patient outcomes," said Dr. Alexander Chiu, an OISG Expert Panel Member.

“We should educate the public on the importance of primary and secondary cancer prevention. Moreover, multi-stakeholders involvement along the patient's pathway is also critical for success," said Dr. Polly Cheung, Founder of The Hong Kong Breast Cancer Foundation and a representative in the OISG Expert Panel.

Based on the report as well as WHO's people-centred healthcare framework, OISG recommends a set of three concrete implementations. 

First, a district-based cancer care system that will integrate multi-disciplinary cancer care services to enhance timely care, improve patients' quality of life and optimize resources. 

Second, to improve cancer drug access. This includes exploring additional financing approaches, further extension of the current risk-sharing scheme, the development of affordable private health insurance coverage and an accelerated drug enlistment process. 

And finally, to engage multi-stakeholders in offering people-centred healthcare for both patients and their family members from prevention, to screening, diagnosis, treatment and palliative care.   [See Factsheet on OISG Recommendations.]

"Everything we recommend in speeding up the process and integrating multi-disciplinary professionals is to aim for a much better quality patient outcomes and quality of life.  Private sectors such as pharmaceutical manufacturers and health insurers must work together with the government and NGOs in narrowing the gaps along the patients' pathway," said Sabrina Chan, Executive Director of The Hong Kong Association of the Pharmaceutical Industry.

Experts from OISG said they will convene regularly with different stakeholders to communicate and explore ways to implement their recommendations for better patient outcomes.